This comprehensive inspection took place on 13 November 2018 and was announced. We gave the registered manager two working days’ notice as the location provided a service to people in their own homes and we needed to confirm a manager would be available when we inspected. This was Somcare Agency Limited’s first inspection since registering with the Care Quality Commission in January 2018.

Somecare Agency Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults, some living with the experience of dementia, people with learning disabilities and people with mental health needs. Most people funded their care through direct payments. At the time of our inspection three people were using the service.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

During the inspection we found risk assessments and risk management plans were not robust and did not have clear guidance for staff to follow to minimise possible risks to people using the service.

The principles of the Mental Capacity Act (2005) were not always being followed to make sure people’s rights were always protected.

Care workers were not always recording when they had supported people to take medicines and therefore we could not be sure people were receiving their medicines as prescribed.

The care plans did not record any information around people’s wishes, views and thoughts about end of life care.

We did not see any accessible information for people. Care plans did not always have information on how to support people with communication. We have made a recommendation to the provider about enabling and supporting people to make or participate in making decisions about their care and treatment.

Care workers had relevant training, were able to identify the types of abuse and knew how to respond to any safeguarding concerns.

There were enough care workers employed to meet the needs of the people using the service. There were safe recruitment systems in place to ensure care workers were suitable to work with people using the service.

Care workers had access to personal protective equipment and infection control training.

When it was part of their support plan, care workers supported people to maintain a balanced diet and people’s care plans included information about their health needs.

Relatives told us they were happy with the care provided. People were treated with kindness and respect and had the same care workers which provided consistency of care.

The provider had a procedure for responding to any complaints they received. People had information on how to make a complaint and knew how to if they needed to.

The service had some systems in place to monitor and improve service delivery. This included a complaints system, telephone feedback and care worker observations.

Relatives of people using the service and care workers told us the manager was accessible and responded to any concerns raised.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to safe care and treatment, consent to care and good governance. You can see what action we told the provider to take at the back of the full version of the report.